Rural Areas Are Less Healthy Than Suburbs, Says Report

Janice Simmons, February 18, 2010

The first set of reports ever produced to provide comparative health data for all 3,000-plus counties in all 50 states was released Wednesday by the Robert Wood Johnson Foundation and University of Wisconsin's Population Health Institute.

The 50-state reports are designed to help public health and community leaders, policymakers, consumers, and others to understand the health of their counties—compared with others within their state—and find ways to improve the overall health of their population.

"We view the country health rankings as an important companion to America's health rankings," said Risa Lavizzo Mourey, MD, president and CEO of the Robert Wood Johnson Foundation at a briefing in Washington, DC. The rankings are important because "they tell us a story about the factors that influence how healthy we are and how long we live," she added.

"They tell us that health depends on more than healthcare, and they tell us health happens in our communities—where we live, learn, work, and play," she said. The rankings are "an important tool in helping to pinpoint health problems—which means more of a likelihood of solving problems."

The foundation worked with the University of Wisconsin to develop a "robust Web site." The Web site provides comparisons on health factors related to health behaviors, clinical care, social and economic factors, and physical environment. The rankings will be used to mark progress over time. "We believe this is a new chapter in our nation's health," she said.

For the first time, people have a tool "to help identify what is making people in every county unhealthy," said Patrick Remington, MD, associate dean for public health at the University of Wisconsin School of Medicine and Public Health. Wisconsin first looked at the variations in healthcare by county beginning in 2003.

"We hope this kind of check up will mobilize community leaders to take action and invest in programs and policy changes that make their counties healthier places to live," he said.

Close attention is paid to morbidity and mortality rates in the counties—how healthy they are and how long they lived. In particular, researchers used five measures to assess the level of overall health or health outcomes by county:

  • The rate of people dying before age 75
  • The percentage of people who reported being in fair or poor health
  • The number of days people reported being in poor physical health
  • The number of days in poor mental health
  • The rate of low birth weight infants

The counties also were ranked on key factors that affect health, such as: smoking, obesity, binge drinking, access to primary care providers, rates of high school graduation, rates of violent crime, air pollution levels, liquor store density, unemployment rates, and number of children living in poverty.

More than 80% of the less healthy areas were found in small or rural areas of the states. Only 2% of the least healthy communities were in suburbs, Remington said.

Janice Simmons Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at
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